Still Catching Up, With a Must-Read STAT Piece on Value, Thinking on Insulin, and More

Still living out of boxes here, but -- on the bright side -- it was steamers and oysters for lunch yesterday, so don’t shed any tears for me. 

Still, there’s a backlog of items to get though. I don’t think any of them are showstoppers, beyond the CMS guidance that we discussed yesterday, but there’s a lot worth bookmarking nonetheless. 

Some quick ones: 

• You ought to give this STAT op-ed -- by three health economists worth paying attention to -- a close read. It lays out a fairly compelling argument for a value-driven approach to drug pricing, with an emphasis on looking at how a medicine benefits society, not just insurance companies. Those who object to the kind of thinking laid out in the piece probably have a vested interest in making health care worse (or more expensive), so the STAT essay creates a good benchmark. 

• This Health Affairs Forefront article, by a DC lawyer and a PhRMA exec, makes the case that the IRA is a uniquely punitive price-setting law. While other countries do plenty of price controls, the worst-case scenario is simply that a medicine doesn’t get reimbursed. Under the IRA, however, a company would have to either pay crippling taxes or remove all of its medicines from Medicare and Medicaid, and the Health Affairs argument points out that no other country uses that kind of broad coercion. 

• This is a weird NYT article about Joe Biden and insulin, in that it feels like a belated effort to match this AP story from last month. Either way, there is kind of a consensus that insulin prices are more of a political phenomenon than a real-world one. I read these articles closely for examples of patients who -- at present -- can’t get affordable access, and it looks like the NYT couldn’t find anyone. There are horror stories of past access challenges, but no one that is having trouble in the current environment. Again: I don’t want to imply that those people don’t exist. I’d just love to have a better sense of who they are … and what the cracks are that they’re falling through. 

• Speaking of insulin, Axios took a look at how federal legislative efforts to solve the “problem” are going. The short answer: not that well. (But, again, it’s also not entirely clear what problem is being solved, so I kind of get the lack of urgency.)

• The Bayh-Dole Coalition has launched a “Save Bayh-Dole” effort designed to push back on the Biden administration’s march-in efforts. It includes an easy web form to let the government know what you think. 

• I should have -- but didn’t -- flagged this Journal of the American Medical Association “Perspective” from ICER’s David Rind that ran last week. In it, he goes after Sarepta’s gene therapy, pointing out gaps in the evidence base and highlighting its cost, all in the context of an upcoming FDA decision on whether the treatment should get full approval. As with so much of Sarepta’s history, what the FDA chooses to do will say a lot more about the FDA than it does about Sarepta. 

• Endpoints has a decent wrap on all of the IRA-related comments from earnings szn. 

• What’s still missing? Well, ISPOR is in full swing, and I’ve seen a ton of really interesting research that I assume isn’t going to get media pickup. But I fully intend to do a broad look at what the conversation is down in Atlanta, because I suspect the attendees there have some worthwhile thoughts on where the industry is headed. 

If there’s anything you’ve seen at ISPOR that you want to make sure to flag, please ping me: [email protected].

Header image via Flickr users Paul Asman and Jill Lenoble.